Brühl P, Hoefer-Janker H, Scheef W, Vahlensieck W
Onkologie. 1979 Jun;2(3):120-4. doi: 10.1159/000214493.
The so-called cystitis due to cyclophosphamide (Cytoxan) is caused by direct contact of the mucosa with alkylating metabolites in acid urine. These alkylating metabolites can be inactivated by instillation of cysteine into the urinary bladder. The cytostatically active metabolites of ifosfamide (Holoxan), a derivative of oxazaphosphorine, are eliminated by the kidneys as well. Their special toxicity is much higher than the toxicity of Cytoxan. The alkylating metabolites of ifosfamide cause urological complications essentially in supravesical areas (tubulopyelo-ureteritis). Some clinical trials demonstrate that increase of diuresis and alkalinization of urine by orally administered Uralyt-U are able to decrease concentration and aggressiveness of those metabolites.
所谓的环磷酰胺（癌得星）所致膀胱炎是由于黏膜与酸性尿液中的烷化代谢产物直接接触引起的。通过向膀胱内灌注半胱氨酸可使这些烷化代谢产物失活。异环磷酰胺（和乐生）是恶唑磷的衍生物，其具有细胞抑制活性的代谢产物也经肾脏排泄。其特殊毒性比癌得星的毒性高得多。异环磷酰胺的烷化代谢产物主要在膀胱以上区域引起泌尿系统并发症（肾小管肾盂输尿管炎）。一些临床试验表明，口服优利通-U增加尿量并碱化尿液能够降低这些代谢产物的浓度和活性。
